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BACKGROUND: In the general population, individuals with minoritized sexual orientation and gender identity have a higher burden of chronic health conditions than heterosexual individuals. However, the extent to which sexual orientation is associated with excess burden of chronic conditions in adolescent and young adult cancer survivors (AYACS) is unknown. METHODS: Lesbian, gay, and bisexual (LGB) AYACSs, LGB individuals without a history of cancer, and heterosexual AYACSs were identified by self-reported data from the cross-sectional National Health Interview Survey (2013-2020). Socioeconomic factors and the prevalence of chronic health conditions were compared between groups using χ2 tests. Logistic regression methods were used to determine the odds of chronic conditions by socioeconomic factors within and between survivor and comparison groups. RESULTS: One hundred seventy LGB cancer survivors, 1700 LGB individuals without a history of cancer, and 1700 heterosexual cancer survivors were included. Compared with heterosexual survivors, LGB survivors were less likely to be married (p = .001) and more likely to have never been married (p < .001). LGB survivors were more likely to have incomes between 100% and 200% of the federal poverty level than LGB individuals without a history of cancer (p = .012) and heterosexual survivors (p = .021) and were less likely to report incomes >200% the federal poverty level. LGB survivors had higher odds of chronic health conditions than LGB individuals without a history of cancer (odds ratio, 2.45; p < .001) and heterosexual survivors (odds ratio, 2.16; p = .003). CONCLUSIONS: LGB AYACSs are at increased risk of having chronic health conditions compared with both LGB individuals without a history of cancer and heterosexual AYACSs.
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Neoplasias , Minorías Sexuales y de Género , Humanos , Adolescente , Adulto Joven , Femenino , Masculino , Estudios Transversales , Identidad de Género , Bisexualidad , Conducta Sexual , Sobrevivientes , Enfermedad Crónica , Neoplasias/epidemiologíaRESUMEN
BACKGROUND: Survivors of adolescent and young adult (AYA) cancer experience significant psychological distress and encounter barriers to accessing mental health care. Few studies have investigated racial/ethnic disparities in psychological health outcomes among AYA survivors, and none have compared outcomes within a racially minoritized population. METHODS: National Health Interview Survey data (2010-2018) were analyzed that identified non-Hispanic Black (hereafter, Black) survivors of AYA cancer and age- and sex-matched Black noncancer controls. Sociodemographic factors, chronic health conditions, modifiable behaviors (smoking and alcohol use), and psychological outcomes were assessed with χ2 tests. Logistic regression models, adjusted for survey weights, were used to evaluate the odds of psychological distress by cancer status after adjusting for covariates. Interactions between variables and cancer status were investigated. RESULTS: The study included 334 Black survivors of AYA cancer and 3340 Black controls. Compared to controls, survivors were more likely to report moderate/severe distress (odds ratio [OR], 1.64; p < .001), use mental health care (OR, 1.53; p = .027), report an inability to afford mental health care (OR, 3.82; p < .001), and use medication for anxiety and/or depression (OR, 2.16; p = .001). Forty-one percent of survivors reported moderate/severe distress, and only 15% used mental health care. Among survivors, ages 18-39 years (vs. 40-64 years) and current smoking (vs. never smoking) were associated with the presence of moderate/severe distress. Among survivors with distress, high poverty status was associated with reduced utilization of mental health care. CONCLUSIONS: A cancer diagnosis for a Black AYA is associated with greater psychological distress within an already vulnerable population.
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Negro o Afroamericano , Supervivientes de Cáncer , Distrés Psicológico , Humanos , Femenino , Masculino , Adulto Joven , Adolescente , Supervivientes de Cáncer/psicología , Supervivientes de Cáncer/estadística & datos numéricos , Adulto , Negro o Afroamericano/psicología , Negro o Afroamericano/estadística & datos numéricos , Neoplasias/psicología , Neoplasias/terapia , Neoplasias/etnología , Aceptación de la Atención de Salud/estadística & datos numéricos , Estrés Psicológico/epidemiología , Servicios de Salud Mental/estadística & datos numéricosRESUMEN
PURPOSE: Survivors of adolescent and young adult (AYA) cancer face significant psychological distress and encounter barriers accessing mental health care. However, limited research exists on psychological health among lesbian, gay, and bisexual (LGB) survivors of AYA cancer, particularly in comparison with heterosexual survivors and LGB individuals without a history of cancer. METHODS: Using the National Health Interview Survey (2013-2018), we identified LGB survivors of AYA cancer, LGB individuals without a history of cancer, and heterosexual survivors of AYA cancer. Sociodemographic, chronic health conditions, modifiable factors (such as smoking and alcohol use), and psychological outcomes were assessed using chi-square tests. Logistic regression models, adjusted for survey weights, evaluated the odds of psychological distress by cancer status after accounting for covariates. Interactions between variables and cancer status were explored. RESULTS: The study comprised 145 LGB survivors, 1450 LGB individuals without a history of cancer, and 1450 heterosexual survivors. Compared to heterosexual survivors, LGB survivors were more likely to report severe distress (aOR = 2.26, p = 0.021) and had higher odds of reporting a mental health care visit (aOR = 1.98, p = 0.003). Odds of severe distress (aOR = 1.36, p = 0.36) and reporting a mental health care visit (aOR = 1.27, p = 0.29) were similar between LGB survivors and LGB individuals without a history of cancer. While 47.8% of LGB survivors reported moderate/severe distress, only 29.7% reported a mental health care visit. CONCLUSION: A history of cancer during the AYA years is associated higher odds of severe psychological distress among LGB survivors compared to heterosexual survivors. However, many LGB survivors with psychological distress have not accessed mental health care.
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Supervivientes de Cáncer , Distrés Psicológico , Minorías Sexuales y de Género , Humanos , Femenino , Masculino , Adulto Joven , Adolescente , Supervivientes de Cáncer/psicología , Supervivientes de Cáncer/estadística & datos numéricos , Minorías Sexuales y de Género/psicología , Minorías Sexuales y de Género/estadística & datos numéricos , Adulto , Neoplasias/psicología , Aceptación de la Atención de Salud/estadística & datos numéricos , Aceptación de la Atención de Salud/psicología , Servicios de Salud Mental/estadística & datos numéricos , Estrés Psicológico/epidemiologíaRESUMEN
This study analyzed the mealtime structure of older adults with dementia in long-term care facilities. The study conducted video observations at 2 long-term care facilities with 10 residents and 24 staff members, resulting in 41 dyads. The average mealtime duration was 12.21 ± 5.16 minutes; the average time of a single intake was 0.21 ± 0.21 minutes; and the median of the eating interval was 0.17 minutes. The average verbal assistance time was 1.41 ± 1.31 minutes; the average verbal assistance frequency was short (23.92 ± 15.50 times). During mealtime, residents had an average of 5.00 ± 4.07 instances of failing to eat properly. The video analysis emphasized the necessity of implementing a mealtime assistance program that incorporates patient-centered education for the staff and ensures sufficient staffing to provide high-quality meals for residents in long-term care facilities.
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Demencia , Cuidados a Largo Plazo , Humanos , Anciano , Ingestión de Alimentos , Casas de Salud , ComidasRESUMEN
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains a potential curative option for treating a variety of hematologic diseases, but acute and chronic graft-versus-host disease (GVHD) remain major barriers limiting efficacy. Acute gut GVHD occurs with marked increases in proinflammatory cytokines (including TNF and IL-6), which we recently demonstrated was exacerbated in obesity resulting in severe gastrointestinal pathology. Given the pleiotropic and overlapping effects of these 2 cytokines, we assessed the impact of dual TNF and IL-6R blockade on GVHD as well as graft-versus tumor (GVT) effects in different mouse GVHD models. Early administration of combined blockade resulted in greater protection and survival from acute gut GVHD compared with single blockade regimens and even development of later chronic skin GVHD. Importantly, double cytokine blockade preserved GVT effects reinforcing that GVT and GVHD can be delineated and may result in greater efficacy in allo-HSCT.
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Antiinflamatorios/uso terapéutico , Enfermedad Injerto contra Huésped/prevención & control , Trasplante de Células Madre Hematopoyéticas , Receptores de Interleucina-6/antagonistas & inhibidores , Inhibidores del Factor de Necrosis Tumoral/uso terapéutico , Animales , Anticuerpos Monoclonales/uso terapéutico , Modelos Animales de Enfermedad , Etanercept/uso terapéutico , Femenino , Efecto Injerto vs Tumor/efectos de los fármacos , Trasplante de Células Madre Hematopoyéticas/métodos , Humanos , Ratones Endogámicos BALB C , Ratones Endogámicos C57BL , Trasplante Homólogo/métodosRESUMEN
PURPOSE: Survivors of adolescent and young adult (AYA) cancer experience psychological distress and insufficient access to mental health care. Few studies have investigated racial/ethnic disparities in psychological health outcomes in this population. This study compared psychological distress, mental health care use, and inability to afford mental health care between Hispanic/Latino survivors of AYA cancer and Hispanic/Latino controls. METHODS: The National Health Interview Survey data (2010-2018) were analyzed to identify Hispanic/Latino survivors of AYA cancer and Hispanic/Latino age- and sex-matched non-cancer controls. Sociodemographic, chronic health, modifiable factors, and psychological outcomes were compared using chi-square tests. Logistic regression models with survey weights were used to assess the log-odds of psychological distress in relation to covariates, along with the cancer group. Interactions were evaluated between each variable and cancer group. RESULTS: The study included 370 Hispanic/Latino survivors of AYA cancer (mean time since diagnosis = 12.34 years) and 3700 Hispanic/Latino controls. Compared to controls, survivors were more likely to report moderate/severe distress (OR = 2.23, p < 0.001), use of mental health care (OR = 2.11, p < 0.001) and inability to afford mental health care (OR = 3.05, p < 0.001). Forty-one percent of survivors reported moderate/severe distress and only 16% utilized mental health care. Among survivors, having more than two chronic health conditions and public insurance (compared to private insurance) were associated with the presence of moderate/severe distress. Among survivors experiencing moderate/severe distress, lack of insurance was associated with decreased utilization of mental health care. CONCLUSIONS: Having cancer as an AYA may exacerbate disparities in psychological health within the Hispanic/Latino population.
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Supervivientes de Cáncer , Servicios de Salud Mental , Neoplasias , Aceptación de la Atención de Salud , Distrés Psicológico , Adolescente , Humanos , Adulto Joven , Hispánicos o Latinos/psicología , Neoplasias/terapia , Neoplasias/psicología , Supervivientes de Cáncer/psicologíaRESUMEN
PURPOSE: Although cancer experiences and health-related quality of life (HRQOL) differ by sex, little is known about how sex affects comorbid conditions, health behaviors, health service utilization, and HRQOL in young adult (YA) cancer survivors. We sought to determine the relationship of sex to these factors in this population. METHODS: This matched case-control, cross-sectional study used data from the Texas Behavioral Risk Factor Surveillance System for 2015-2019. YA survivors aged 18-39 years, were matched to controls. Chi-square and multiple logistic regressions were used to assess the relationship between sex and the measured factors. RESULTS: The analysis included 276 YA survivors and 828 controls. Male survivors were more likely than male controls to have a depressive disorder (OR = 3.06, p = 0.007), smoke (OR = 3.87, p < 0.001), and forgo health care because of cost (OR = 5.60, p < 0.001). Female survivors were more likely than female controls to have at least one comorbidity (OR = 3.52, p < 0.001), forgo health care because of cost (OR = 3.03, p < 0.001), and report poorer HRQOL (aORs = 1.52-2.22, p < 0.05). Female survivors were more likely to have at least one comorbid condition (aOR = 1.70, p = 0.02) than male survivors. CONCLUSION: YA cancer survivors differed in their health outcomes from both the general population and by sex. Tailored, sex-based interventions are needed to decrease long-term morbidity and improve HROQL in this population.
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Supervivientes de Cáncer , Neoplasias , Humanos , Masculino , Femenino , Adulto Joven , Calidad de Vida , Estudios Transversales , Caracteres Sexuales , Conductas Relacionadas con la Salud , Atención a la Salud , Aceptación de la Atención de SaludRESUMEN
Equine parvovirus-hepatitis (EqPV-H) is the causative agent of Theiler's disease, or severe acute hepatic necrosis, in horses. However, it is poorly understood whether EqPV-H is associated with other histologic findings in horses with clinical liver disease. The objective of this study was to examine the prevalence and severity of EqPV-H infections in diagnostic liver samples. Archived formalin-fixed, paraffin-embedded (FFPE) liver samples (n = 98) from Cornell University and University of California, Davis, collected between 2007 and 2022 were evaluated for 15 individual histologic features and by EqPV-H in situ hybridization. EqPV-H was detected in 48% (n = 47) of samples. The most common histologic features of EqPV-H-positive samples included individual hepatocyte death (n = 40, 85%), lobular infiltrates (n = 38, 80%), portal infiltrates (n = 35, 74%), and ductular reaction (n = 33, 70%). Centrilobular necrosis, portal infiltrate, and individual hepatocyte death were positively associated with high viral load. Neutrophil infiltrates, bridging fibrosis, and portal edema were negatively associated with a high viral load. Only 4 of 49 tested samples were positive for equine hepacivirus by polymerase chain reaction (PCR), but the PCR assay was unreliable for FFPE tissues. In summary, this study demonstrates that EqPV-H is common in a variety of liver pathologies and should be considered as a differential diagnosis in cases of hepatitis other than Theiler's disease.
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AIMS AND OBJECTIVES: To identify the most accurate postoperative delirium screening tools for detecting postoperative delirium among patients who underwent general anaesthesia surgery in general wards. BACKGROUND: The lack of detection of postoperative delirium can negatively affect the patient's condition, along with their postoperative treatment and rehabilitation, and it can prolong their hospitalisation, persists cognitive dysfunction and increases mortality. Screening for postoperative delirium in hospitalised patients as nursing assessment is routine clinical practice for early detection. DESIGN: A systematic review and meta-analysis. METHODS: MEDLINE, Embase, CINAHL, KoreaMed and Cochrane electronic databases were searched using the key words delirium, postoperative, assessment or screening, and adult for articles published up to April 2020, with no limit on the year of publishing. Only prospective cohort studies reporting sensitivity and specificity values were included. We followed the recommendations of the Cochrane Handbook of Diagnostic Test Accuracy Reviews and the PRISMA checklist. The Quality Assessment of the Diagnostic Accuracy Studies-2 tool was used for data extraction and quality assessment, while a bivariate random-effects meta-analysis model was used for pooling and comparing diagnostic accuracy and providing a summary of evidence. RESULTS: Six delirium assessment tools were evaluated from nine papers including 3088 patients. Due to the limited number of papers, the meta-analysis included the Confusion Assessment Method (CAM) and its variants, Delirium Detection Score (DDS) and Nurses' Delirium Screening Checklist (NuDESC). Overall, NuDESC demonstrated higher sensitivity than CAM or DDS, while all showed high specificity (0.90 or greater). CONCLUSION: This review suggested that NuDESC can be employed as an accurate screening tool with high specificity for assessing postoperative delirium during routine checkups. However, it is necessary to consider suitable cut-off values, which is the reference point, in accordance with the clinical setting and the patients' condition. RELEVANCE TO CLINICAL PRACTICE: NuDESC reported the best evidence of diagnostic accuracy, and we recommend clinical nurses to employ this easy-to-use and validated tool for daily screening of postoperative delirium in general wards to facilitate its early detection and the accurate estimation of its prevalence.
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Anestésicos , Delirio , Delirio del Despertar , Humanos , Adulto , Delirio del Despertar/diagnóstico , Delirio/diagnóstico , Estudios Prospectivos , Anestesia GeneralRESUMEN
This case series describes the use of in vivo confocal microscopy in the diagnosis and treatment of mycotic keratitis in two owls (one Bubo scandiacus, one Strix varia) and one woodcock (Scolopax minor). Each bird was at increased risk of fungal infection due to recent injury or stress. Ophthalmic findings in all birds included blepharospasm, ocular discharge, ulcerative keratitis, white or yellow corneal plaques, and anterior uveitis. Fungal hyphae were identified in corneal samples from all three eyes examined cytologically and in all three eyes by using in vivo confocal microscopy. Aspergillus fumigatus was isolated from a corneal culture in one bird. Despite medical treatment, progressive ocular disease prompted enucleation in two birds. Fungal hyphae were detected by histopathology in one of the two enucleated eyes. In vivo confocal microscopy aided the diagnosis of fungal keratitis in all birds and was the only diagnostic method that allowed immediate, real-time quantification of the extent (area and depth) and severity of mycotic keratitis.
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Úlcera de la Córnea , Infecciones Fúngicas del Ojo , Queratitis , Animales , Úlcera de la Córnea/veterinaria , Úlcera de la Córnea/patología , Queratitis/diagnóstico , Queratitis/veterinaria , Queratitis/microbiología , Infecciones Fúngicas del Ojo/diagnóstico , Infecciones Fúngicas del Ojo/veterinaria , Infecciones Fúngicas del Ojo/microbiología , Córnea , Microscopía Confocal/veterinariaRESUMEN
BACKGROUND: In older patients with dementia, functional dependence on individuals affects their eating behavior, leading to difficulties with meals. In addition to individual factors, several social, cultural, and environmental factors influence mealtime difficulties in older individuals with dementia. Therefore, a measure is required to evaluate the difficulty of eating, considering the different interacting phenomena. METHODS: Mealtime Difficulties Scale for older adults with Dementia (MDSD) was developed through a literature review. A pilot test was undertaken to confirm the meaning of the items and the relevance of mealtime difficulties for older patients with dementia. A panel of six experts examined the content validity of the MDSD. Convenience sampling was used to recruit direct care workers from long-term care facilities, of which 150 were recruited for exploratory factor analysis (EFA) and 208 for confirmatory factor analysis (CFA). RESULTS: The final version of the MDSD included 19 items, with a Cronbach's α of 0.91. The EFA identified three factors ("functional," "caregiving," and "behavioral") that account for 54.6% of the total variance. The CFA confirmed the validity of the instrument. CONCLUSIONS: Evidence to substantiate the validity and reliability of MDSD was found. While this tool has limitations in that it does not ensure convergent validity, it can be considered significant as it can assess the mealtime difficulty among older patients with dementia from different perspectives.
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Demencia , Cuidados a Largo Plazo , Anciano , Análisis Factorial , Humanos , Comidas , Psicometría , Reproducibilidad de los Resultados , Encuestas y CuestionariosRESUMEN
BACKGROUND: Internet technologies have become important for older adults to not only seek, understand, and evaluate information on health management but also apply and share acquired knowledge. Despite the disparity in e-health literacy among older adults, which affects health outcomes, its conceptual definition has not been distinctly clarified in previous studies. This study aimed to analyse the concept of e-health literacy among older adults and to identify its contexts in the nursing field. METHODS: We identified concepts, attributes, antecedents, and consequences of e-health literacy in older adults using Rodgers' evolutionary approach to various fields of study, time, and cultural differences. A literature search was conducted using the National Assembly Library, Research Information Sharing Service, National Digital Science Library, DataBase Periodical Information Academic, PubMed, Cumulative Index to Nursing and Allied Health Literature, Excerpta Medica database, and Cochrane. RESULTS: A total of 28 studies were included, and we categorised the following three attributes: active information seeking, two-way interactive communication, and information utilization/sharing. The antecedents included personal factors, health status, socioeconomic factors, cultural factors, and attitudes toward the Internet while the consequences included increased health interest, health behaviour promotion, and active decision-making. CONCLUSIONS: As e-health literacy in older adults affects their health and quality of life, this study clarifies the concept and provides a conceptual framework for nursing practice and research. Further studies are needed to identify and expand the constantly evolving concept of e-health literacy in older adults.
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Alfabetización en Salud , Anciano , Conductas Relacionadas con la Salud , Promoción de la Salud , Humanos , Conocimiento , Calidad de VidaRESUMEN
PURPOSE: The purpose of this study is to identify and compare the unmet needs of adolescents and young adults (AYAs) with cancer by age and gender. DESIGN AND METHODS: This is a mixed-methods study to analyze textual data from blog posts on AYAs' unmet needs. Themes were identified using a qualitative descriptive method with content analysis, and a quantitative method was used to compare themes by age and gender. RESULTS: The findings from blog posts of 100 AYAs showed that AYAs with cancer expressed somewhat different needs by age and gender. Young adults (26-39 years) with cancer tended to describe significantly more feelings of fear (p = .043) and parenting needs (p < .001) and significantly fewer educational needs (p < .001) than did emerging adults (18-25 years) with cancer. Female AYAs with cancer described significantly more feelings of guilt (p = .020), sexual needs (p = .003), fertility issues (p = .023), and social needs (p = .013) than did male AYAs with cancer. There were no statistically significant differences in the remaining themes between age and gender groups, although how they described unmet needs differed qualitatively. CONCLUSIONS: AYAs with cancer have various unmet needs and their unmet needs were different by age and gender. PRACTICE IMPLICATIONS: Nurses should proactively provide integrated systematic screening by offering a safe, non-judgmental environment to encourage AYAs to express their needs across their cancer journey. Nurses also should respond with developmentally appropriate support, resources, and referrals based on these expressed needs.
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Neoplasias , Medios de Comunicación Sociales , Adolescente , Femenino , Humanos , Masculino , Neoplasias/terapia , Proyectos de Investigación , Adulto JovenRESUMEN
A 27-y-old female black-handed spider monkey (Ateles geoffroyi) was evaluated 13 d after an ovariohysterectomy because of abdominal distension, anorexia, and absent urination. The animal was diagnosed with a uroabdomen and urethral obstruction from computed tomographic findings and fluid creatinine levels. During exploratory laparotomy, a defect in the right ureter was confirmed as the source of the uroabdomen. Utilizing intraoperative fluoroscopy, a urethral obstruction with an irregular luminal filling defect was evident. A self-expanding nitinol urethral stent was placed, and a ureteral transposition was performed. Two months after the procedure, the animal developed dysuria, a urinary tract infection, recurrent bladder distension and a partial urethral obstruction. Treatment with prazosin 1 mg/kg PO q12h improved urination. Reobstruction of the urethra occurred 17 mo postsurgery, and the animal was euthanatized. On postmortem examination, the animal had ingrowth into the stent with proliferative granulation tissue, detrusor muscle degeneration, pelvic adhesions, cystitis, pyelonephritis, and hydronephrosis.
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Ateles geoffroyi , Cistotomía/veterinaria , Enfermedades de los Monos/cirugía , Stents/veterinaria , Uréter/patología , Animales , Animales de Zoológico , Cistotomía/métodos , Femenino , Uréter/cirugíaRESUMEN
BACKGROUND: Canine visceral hemangiosarcoma (HSA) is a highly aggressive cancer of endothelial origin that closely resembles visceral angiosarcoma in humans, both clinically and histopathologically. Currently there is an unmet need for new diagnostics and therapies for both forms of this disease. The goal of this study was to utilize Chromatin run-on sequencing (ChRO-seq) and immunohistochemistry (IHC) to identify gene and protein expression signatures that may be important drivers of HSA progression. RESULTS: ChRO-seq was performed on tissue isolated from 17 HSA samples and 4 normal splenic samples. Computational analysis was then used to identify differentially expressed genes and these factors were subjected to gene ontology analysis. ChRO-seq analysis revealed over a thousand differentially expressed genes in HSA tissue compared with normal splenic tissue (FDR < 0.005). Interestingly, the majority of genes overexpressed in HSA tumor tissue were associated with extracellular matrix (ECM) remodeling. This observation correlated well with our histological analysis, which found that HSA tumors contain a rich and complex collagen network. Additionally, we characterized the protein expression patterns of two highly overexpressed molecules identified in ChRO-seq analysis, podoplanin (PDPN) and laminin alpha 4 (LAMA4). We found that the expression of these two ECM-associated factors appeared to be largely limited to transformed endothelial cells within the HSA lesions. CONCLUSION: Outcomes from this study suggest that ECM remodeling plays an important role in HSA progression. Additionally, our study identified two potential novel biomarkers of HSA, PDPN and LAMA4. Interestingly, given that function-blocking anti-PDPN antibodies have shown anti-tumor effects in mouse models of canine melanoma, our studies raise the possibility that these types of therapeutic strategies could potentially be developed for treating canine HSA.
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Enfermedades de los Perros/patología , Matriz Extracelular/patología , Hemangiosarcoma/veterinaria , Neoplasias del Bazo/veterinaria , Animales , Biomarcadores de Tumor , Cromatina/genética , Cromatina/metabolismo , Mapeo Cromosómico , Perros , Regulación Neoplásica de la Expresión Génica , Ontología de Genes , Hemangiosarcoma/genética , Hemangiosarcoma/metabolismo , Glicoproteínas de Membrana/metabolismo , Bazo/metabolismo , Neoplasias del Bazo/genética , Neoplasias del Bazo/metabolismoRESUMEN
BACKGROUND: Sudden unexpected infant death (SUID), which includes the diagnosis of sudden infant death syndrome (SIDS), is a leading cause of infant mortality in the United States. Despite prevention efforts, many parents continue to create unsafe infant sleep environments and use potentially dangerous infant sleep and monitoring devices, ultimately leading to sleep-related infant deaths. Analyzing Facebook conversations regarding SIDS may offer a unique maternal perspective to guide future research and prevention efforts. OBJECTIVE: This study aims to describe and analyze conversations among mothers engaged in discussions about SIDS on a Facebook mother's group. We were interested in understanding maternal knowledge of SIDS, identifying information sources for SIDS, describing actual infant sleep practices, exploring opinions regarding infant sleep products and monitoring devices, and discovering evidence of provider communication regarding SIDS. METHODS: We extracted and analyzed 20 posts and 912 comments from 512 mothers who participated in a specific Facebook mother's group and engaged in conversations about SIDS. There were 2 reviewers who coded the data using qualitative descriptive content analysis. Themes were induced after discussion among researchers and after the study objectives were addressed. RESULTS: The theme of social support emerged, specifically informational and emotional support. A variety of informational sources for SIDS and safe sleep were identified, as was a continuum of infant sleep practices (ranging from unsafe to safe sleep per the American Academy of Pediatrics standards). There was widespread discussion regarding infant sleep products and monitoring devices. Embedded within conversations were (1) confusion among commonly used medical terminology, (2) the practice of unsafe infant sleep, (3) inconsistency in provider communication about SIDS, and (4) maternal anxiety regarding SIDS. CONCLUSIONS: We uncovered new findings in this analysis, such as the commonality of infant sleep products and monitoring devices and widespread maternal anxiety regarding SIDS. Additionally, mothers who participated in the Facebook group provided and received informational and emotional support regarding SIDS via this social media format. Such results can guide future prevention efforts by informing health communication regarding SUID and safe sleep. Future provider and public health agency communication on the topic of SUID and safe sleep should be simple and clear, address infant sleep products and monitoring devices, address maternal anxiety regarding SIDS, and address the common practice of unsafe sleep.
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Medios de Comunicación Sociales/normas , Muerte Súbita del Lactante/prevención & control , Adulto , Femenino , Humanos , Lactante , Recién Nacido , Investigación Cualitativa , Factores de RiesgoRESUMEN
PURPOSE: Religion can be important in the everyday lives of persons with epilepsy (PWE). However, there is little research on religion, as it relates to individuals with epilepsy. We determined a relationship between religious coping strategies and psychological distress in Korean adults with epilepsy who had a religious affiliation. METHODS: This cross-sectional study was conducted in outpatient clinics. Religiosity and religious coping strategies were assessed using the Duke University Religion Index (DUREL) and the Brief Religious Coping Scale (B-RCOPE). Psychological distress was measured using the Hospital Anxiety Depression Scale (HADS). Univariate and multivariate linear regression analyses were performed. RESULTS: A total of 88 participants were included. Positive religious coping strategies were more likely utilized than negative religious coping (pâ¯<â¯001). Religiosity was positively correlated with positive coping (râ¯=â¯0.439, pâ¯<â¯0.001) but was not correlated with negative coping. Negative coping was significantly related to higher levels of anxiety (ßâ¯=â¯0.237, standard error (SE)â¯=â¯0.107, pâ¯<â¯0.05) and depressive symptoms (ßâ¯=â¯0.260, SEâ¯=â¯0.095, pâ¯<â¯0.01), after controlling for religiosity and other confounding factors. However, positive coping was not related to anxiety and depressive symptoms. The two types of coping strategies were positively related to each other (râ¯=â¯0.304, pâ¯<â¯0.01). CONCLUSIONS: We found significant positive associations between negative religious coping and anxiety and depressive symptoms in PWE. Positive religious coping was not related to anxiety and depressive symptoms.
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Adaptación Psicológica , Ansiedad/psicología , Depresión/psicología , Epilepsia/psicología , Religión y Psicología , Estrés Psicológico/psicología , Adulto , Ansiedad/etnología , Estudios Transversales , Depresión/etnología , Epilepsia/etnología , Femenino , Humanos , Masculino , Persona de Mediana Edad , República de Corea/etnología , Estrés Psicológico/etnologíaRESUMEN
This study aimed to evaluate the effects of cinnamamides on atopic dermatitis (AD) and the mechanisms underlying these effects. To this end, the actions of two cinnamamides, (E)-3-(4-hydroxyphenyl)-N-phenylethyl acrylamide (NCT) and N-trans-coumaroyltyramine (NCPA), were determined on AD by orally administering them to mice. Oral administration of the cinnamamides ameliorated the increase in epidermal and dermal thickness as well as mast cell infiltration. Cinnamamides suppressed serum immunoglobulin (Ig) levels and expression of T-helper (Th)1/Th2 cytokines. Moreover, cinnamamides suppressed interleukin (IL)-4, which plays a crucial role in preparing naïve clusters of differentiation (CD)4+ T cells, and decreased the cervical lymph node size and weight. Interestingly, in almost all cases, NCPA exhibited higher anti-AD activity compared to NCT. These results strongly indicate that NCPA may have potential as an anti-AD agent, and further mechanistic comparative studies of NCT and NCPA are required to determine the cause of differences in biological activity.
Asunto(s)
Linfocitos T CD4-Positivos/efectos de los fármacos , Cinamatos/farmacología , Dermatitis Atópica/tratamiento farmacológico , Interleucina-4/antagonistas & inhibidores , Administración Oral , Animales , Linfocitos T CD4-Positivos/metabolismo , Diferenciación Celular/efectos de los fármacos , Cinamatos/administración & dosificación , Cinamatos/química , Relación Dosis-Respuesta a Droga , Inmunoglobulinas/biosíntesis , Interleucina-4/metabolismo , Ganglios Linfáticos/efectos de los fármacos , Ratones , Ratones Endogámicos BALB C , Estructura Molecular , Tamaño de los Órganos/efectos de los fármacos , Relación Estructura-ActividadRESUMEN
Loliolide is a monoterpenoid hydroxylactone present in freshwater algae that has anti-inflammatory and antiaging activity; however, its effects on ultraviolet-damaged skin have yet to be elucidated. This study investigated the antiapoptosis and wound-healing effects of loliolide using HaCaT cells (a human keratinocyte cell line). Loliolide inhibited the expression of reactive oxygen species (ROS) induced by ultraviolet radiation as well as wrinkle formation-related matrix metalloproteinase genes and increased the expression of the damage repair-related gene SIRT1. The apoptosis signaling pathway was confirmed by Western blot analysis, which showed that loliolide was able to reduce the expression of caspases 3, 8, and 9, which are related to ROS-induced apoptosis. In addition, Western blotting, reverse-transcription polymerase chain reaction (PCR), and real-time PCR analyses showed that loliolide enhanced the expression of the epidermal growth factor receptor signaling pathway (PI3K, AKT) and migration factors, such as K6, K16, and K17; keratinocyte growth factor; and inflammatory cytokines, such as interleukin (IL)-1, IL-17, and IL-22 expressed during the cellular scratching process, suggesting a putative wound-healing ability. Because of the antiapoptosis and antiscratching effects on skin of both loliolide and loliolide-rich Prasiola japonica ethanol extract, we consider the former to be an important compound used in the cosmeceutical industry.